| NPI | 1386878874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MD D79233) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MD450575) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2022-07-21 |